螺旋CT在胃癌术前T分期中的价值

Values of spiral CT in the preoperative T-staging of gastric carcinoma

目的:研究胃癌多层螺旋CT(MSCT)平扫及增强三期扫描的影像特点,并结合多平面重建(MPR)探讨其对胃癌T分期的应用价值。方法:回顾性分析我院经病理或手术证实63例胃癌患者的CT资料,分析MSCT三期扫描的影像特点,对其进行术前T分期,并与临床术后病理分期进行对比。结果:横轴位图像T1a期准确率为20%(1/5);T1b期准确率为40%(2/5);T2期准确率为57.1%(4/7);T3期准确率为58.3%(7/12);T4a期准确率为66.7%(18/27);T4b期准确率为71.4%(5/7);总准确率为58.7%(37/63)。横轴位结合MPR T1a期准确率为60%(3/5);T1b期准确率60%(3/5);T2期准确率为71.4%(5/7);T3期准确率为75.0%(9/12);T4a期准确率为81.5%(22/27);T4b期准确率为100%(7/7);总准确率为77.8%(49/63);比较两者对胃癌术前分期的准确率可以发现横轴位结合MPR对T分期的准确率高于横轴位T分期准确率(P<0.05),差异有统计学意义。结论:MSCT横轴位结合MPR图像能提高胃癌患者术前T分期的准确性。

Objective：To investigate the image feature of multi-slice CT（MSCT） in plain scanning and enhanced three-phase scanning in gastric carcinoma, and to discuss the application value in preoperative T-staging of gastric carcinoma based on multi-planar reconstruction （MPR）.Methods：CT information was obtained in 63 cases of pathologically or surgically confirmed gastric carcinoma in our hospital, and retrospectively analyzed for the image features of MSCT in three-phase scanning.Then preoperative T-staging of gastric carcinoma by the image data was compared with postoperative pathological staging. Results ： Accuracy rate by transverse images was 20% （ 1/5 ） , 40% （ 2/5 ） , 57.1% （ 4/7 ） , 58.3 % （ 7/12 ） , 66.7 % （ 18/27 ） and 71.4 % （ 5/7 ） , respectively for T1a,T1b,T2 ,T3 ,T4a and T4b.The overall accuracy rate was 58.7% （ 37/63 ） .The accurate rate by MSCT with MPR was 60% （ 3/5 ） , 60% （ 3/5 ） , 71.4%（5/7） ,75.0%（9/12） ,81.5%（22/27） and 100%（7/7） ,respectively for Tla,Tlb,T2,T3,T4a and T4b.The overall accuracy rate was 77.8% （49/63） .MSCT by transverse view plus MPR resulted in higher accuracy rate of preoperative T-staging of gastric cancer than that by simple transverse view.The difference was statistically significant （P〈0.05）.Conclusion：MSCT by transverse view combining with MPR can improve the accuracy rate of preoperative T-staging of gastric carcinoma.